Relationship between Icodextrin use and decreased level of small low-density lipoprotein cholesterol fractioned by high-performance gel permeation chromatographyReport as inadecuate




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BMC Nephrology

, 14:234

Clinical Research

Abstract

BackgroundBecause of the absorption of glucose in peritoneal dialysis PD solution, PD patients show an atherogenic lipid profile, which is predictive of poor survival in PD patients. Lipoprotein subclasses consist of a continuous spectrum of particles of different sizes and densities fraction. In this study, we investigated the lipoprotein fractions in PD patients with controlled serum low-density lipoprotein LDL cholesterol level, and evaluated the effects of icodextrin on lipid metabolism.

MethodsForty-nine PD patients were enrolled in this cross-sectional study in Japan. The proportions of cholesterol levels to total cholesterol level cholesterol proportion in 20 lipoprotein fractions were measured using an improved method of high-performance gel permeation chromatography HPGPC.

ResultsTwenty-six patients used icodextrin. Although no significant differences in cholesterol levels in LDL and high-density lipoprotein HDL were observed between the patients using icodextrin icodextrin group and control groups, HPGPC showed that the icodextrin group had significantly lower cholesterol proportions in the small LDL t-test, p=0.053 and very small LDL p=0.019, and significantly higher cholesterol proportions in the very large HDL and large HDL than the control group p=0.037; p=0.066, respectively. Multivariate analysis adjusted for patient characteristics and statin use showed that icodextrin use was negatively associated with the cholesterol proportions in the small LDL p=0.037 and very small LDL p=0.026, and positively with those in the very large HDL p=0.040, large HDL p=0.047, and medium HDL p=0.009.

ConclusionsHPGPC showed the relationship between icodextrin use and the cholesterol proportions in lipoprotein fractions in PD patients. These results suggest that icodextrin may improve atherogenic lipid profiles in a manner different from statin.

KeywordsPeritoneal dialysis Icodextrin Low density lipoprotein Atherosclerosis Statin Chromatography AbbreviationsPDPeritoneal dialysis

LDLLow-density lipoprotein

DMDiabetes mellitus

HPGPCHigh-performance gel permeation chromatography

HDLHigh-density lipoproteins

CVDCardiovascular disease

K-DOQIKidney disease outcomes quality initiative

TGTriglyceride

CMChylomicron

F1Fraction 1

VLDLVery-low-density lipoprotein

cholesterol proportionproportion of cholesterol level in each lipoprotein fraction to total cholesterol level

SDStandard deviation

BMIBody mass index

icodextrin grouppatients using icodextrin

control grouppatients not using icodextrin

CRPC-reactive protein

D-P CrDialysate-plasma creatinine ratio.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2369-14-234 contains supplementary material, which is available to authorized users.

Eiichiro Kanda, Masumi Ai, Asami Iwamoto, Mitsuyo Okazaki, Yoshitaka Maeda, Sei Sasaki and Masayuki Yoshida contributed equally to this work.

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Author: Eiichiro Kanda - Masumi Ai - Asami Iwamoto - Mitsuyo Okazaki - Yoshitaka Maeda - Sei Sasaki - Masayuki Yoshida

Source: https://link.springer.com/



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